Yao De-Zhen, Wang Li-Jie
Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Jun 15;24(6):620-625. doi: 10.7499/j.issn.1008-8830.2202099.
To investigate the incidence and mortality of gastrointestinal dysfunction in children with sepsis, the application of near-infrared spectroscopy (NIRS) in monitoring mesenteric regional tissue oxygen saturation (rSO), and the association between rSO and gastrointestinal dysfunction.
In this prospective study, 79 children with sepsis in the pediatric intensive care unit (sepsis group) and 40 children who underwent physical examination in the Department of Child Healthcare (healthy control group) from January to December, 2021 were enrolled as subjects. The related medical data were collected, including general information on admission and at discharge, treatment during hospitalization, and laboratory examination results. NIRS was used to measure mesenteric rSO. Clinical characteristics were compared between the patients with and without gastrointestinal dysfunction.
For the 79 children with sepsis, the incidence rate of gastrointestinal dysfunction was 49% (39/79), and the mortality rate of the children with gastrointestinal dysfunction was 26% (10/39). The children with gastrointestinal dysfunction had a longer duration of mechanical ventilation and a higher 28-day mortality rate (<0.05). The children with gastrointestinal dysfunction had a significantly lower median rSO (64%) than the children without gastrointestinal dysfunction (72%) and the healthy control group (78%) (<0.05).
There are high incidence and mortality rates of gastrointestinal dysfunction in children with sepsis, and the reduction in rSO may be associated with the development of gastrointestinal dysfunction.
探讨脓毒症患儿胃肠功能障碍的发生率和死亡率、近红外光谱技术(NIRS)在监测肠系膜区域组织氧饱和度(rSO)中的应用以及rSO与胃肠功能障碍之间的关联。
本前瞻性研究选取2021年1月至12月在儿科重症监护病房的79例脓毒症患儿(脓毒症组)和40例在儿童保健科进行体格检查的儿童(健康对照组)作为研究对象。收集相关医学数据,包括入院和出院时的一般信息、住院期间的治疗情况以及实验室检查结果。采用NIRS测量肠系膜rSO。比较有无胃肠功能障碍患儿的临床特征。
79例脓毒症患儿中,胃肠功能障碍的发生率为49%(39/79),胃肠功能障碍患儿的死亡率为26%(10/39)。胃肠功能障碍患儿的机械通气时间更长,28天死亡率更高(<0.05)。胃肠功能障碍患儿的rSO中位数(64%)显著低于无胃肠功能障碍患儿(72%)和健康对照组(78%)(<0.05)。
脓毒症患儿胃肠功能障碍的发生率和死亡率较高,rSO降低可能与胃肠功能障碍的发生有关。